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Submitted URL: https://exponea-cdn.dnb.com/dnb-prod-v2/e/.eJwTUtizo7REcatq48GKMwW7Uh-pvGCocY2T_an_9PcnpW7XjDyp1IySkoJiK339Er281IqSzLzi0qLEv...
Effective URL: https://app.nextinsurance.com/quote/get-started?serial=99159&affiliate_id=6497&partner_campaign_id=DB_DM_Email_2025&xnpe_tifc=...
Submission: On November 26 via manual from US — Scanned from US
Effective URL: https://app.nextinsurance.com/quote/get-started?serial=99159&affiliate_id=6497&partner_campaign_id=DB_DM_Email_2025&xnpe_tifc=...
Submission: On November 26 via manual from US — Scanned from US
Form analysis 1 forms found in the DOM
<form _ngcontent-ng-c2430989347="" novalidate="" data-test="lead-form-form" class="lead-form ng-untouched ng-pristine ng-invalid"><ni-cob-selection _ngcontent-ng-c2430989347="" data-test="cob-selection" _nghost-ng-c1554117338=""
class="ng-star-inserted">
<div _ngcontent-ng-c1554117338="" class="dropdown-question form-control"><label _ngcontent-ng-c1554117338="" for="cob" class="ni-input-label-rb"> What type of work do you do? </label><ng-select _ngcontent-ng-c1554117338="" ng-select-rb=""
data-test="cob-input" autocomplete="off" labelforid="cob" id="cob" bindlabel="name" bindvalue="value" niformfieldvalidationerrormessage=""
class="ni-select search-display ng-select-searchable ng-select-clearable ng-select ng-select-single ng-untouched ng-pristine ng-invalid">
<div class="ng-select-container">
<div class="ng-value-container">
<div class="ng-placeholder">Accountant, Retail Stores</div><!----><!---->
<div role="combobox" aria-haspopup="listbox" class="ng-input" aria-expanded="false"><input aria-autocomplete="list" type="text" autocorrect="off" autocapitalize="off" autocomplete="off" id="cob"></div>
</div><!----><!----><span class="ng-arrow-wrapper"><span class="ng-arrow"></span></span>
</div><!---->
</ng-select>
<div class="invalid-error-message p-xs" data-test="form-field-validation-error-message" role="status"></div>
</div>
</ni-cob-selection><!---->
<div _ngcontent-ng-c2430989347="" class="form-control" data-test="51-states"><label _ngcontent-ng-c2430989347="" for="state" class="ni-input-label-rb"> State </label><ng-select _ngcontent-ng-c2430989347="" ng-select-rb="" formcontrolname="state"
data-test="state-input" bindlabel="name" bindvalue="id" autocomplete="off" labelforid="state" id="state" niformfieldvalidationerrormessage=""
class="ni-select search-display ng-select-searchable ng-select-clearable ng-select ng-select-single ng-untouched ng-pristine ng-valid">
<div class="ng-select-container ng-has-value">
<div class="ng-value-container">
<div class="ng-placeholder">Search state</div>
<div class="ng-value ng-star-inserted"><!----><span aria-hidden="true" class="ng-value-icon left ng-star-inserted">×</span><span class="ng-value-label ng-star-inserted">New York</span><!----></div><!----><!----><!----><!---->
<div role="combobox" aria-haspopup="listbox" class="ng-input" aria-expanded="false"><input aria-autocomplete="list" type="text" autocorrect="off" autocapitalize="off" autocomplete="off" id="state"></div>
</div><!----><span tabindex="0" class="ng-clear-wrapper ng-star-inserted" title="Clear all"><span aria-hidden="true" class="ng-clear">×</span></span><!----><span class="ng-arrow-wrapper"><span class="ng-arrow"></span></span>
</div><!---->
</ng-select>
<div class="invalid-error-message p-xs" data-test="form-field-validation-error-message" role="status"></div>
</div>
<div _ngcontent-ng-c2430989347="" class="form-control"><label _ngcontent-ng-c2430989347="" data-test="email-label" for="email" class="ni-input-label-rb"> Email Address </label>
<div _ngcontent-ng-c2430989347="" data-test="email-address-helper-text" class="p-xs_sm email-address-helper-text"> We only use your email to provide services. You can opt out at any time. <!----><!----></div><input _ngcontent-ng-c2430989347=""
data-test="email-input" type="email" formcontrolname="email" id="email" autocomplete="email" niformfieldvalidationerrormessage="" class="ni-input-rb input-email ng-untouched ng-pristine ng-invalid">
<div _ngcontent-ng-c2430989347="" class="invalid-error-message p-xs" data-test="form-field-validation-error-message" role="status"></div><!----><!---->
</div>
<div _ngcontent-ng-c2430989347="" class="get-quote-container"><ni-button-rb _ngcontent-ng-c2430989347="" data-test="submit" class="get-quote-btn ng-star-inserted" _nghost-ng-c2602208494=""><button _ngcontent-ng-c2602208494="" tabindex="0"
data-test="ni-button" class="ni-button-rb p-sm_md default" disabled="">Continue <!----><fa-icon _ngcontent-ng-c2602208494="" data-test="loading-icon" size="lg" animation="spin" class="ng-fa-icon loading-icon" hidden=""><svg role="img"
aria-hidden="true" focusable="false" data-prefix="fas" data-icon="circle-notch" class="svg-inline--fa fa-circle-notch fa-spin fa-lg" xmlns="http://www.w3.org/2000/svg" viewBox="0 0 512 512">
<path fill="currentColor"
d="M222.7 32.1c5 16.9-4.6 34.8-21.5 39.8C121.8 95.6 64 169.1 64 256c0 106 86 192 192 192s192-86 192-192c0-86.9-57.8-160.4-137.1-184.1c-16.9-5-26.6-22.9-21.5-39.8s22.9-26.6 39.8-21.5C434.9 42.1 512 140 512 256c0 141.4-114.6 256-256 256S0 397.4 0 256C0 140 77.1 42.1 182.9 10.6c16.9-5 34.8 4.6 39.8 21.5z">
</path>
</svg></fa-icon></button></ni-button-rb><!---->
<div _ngcontent-ng-c2430989347="" data-test="terms-of-use" class="p-xs terms-of-use ng-star-inserted"><span _ngcontent-ng-c2430989347="">By clicking "Continue", you agree to the</span><span
_ngcontent-ng-c2430989347=""><a _ngcontent-ng-c2430989347="" target="_blank" href="https://track.nextinsurance.com/links?serial=95103"> Terms of Use</a> and
<a _ngcontent-ng-c2430989347="" target="_blank" href="https://track.nextinsurance.com/links?serial=95104">Privacy Policy</a></span><span _ngcontent-ng-c2430989347="" class="ng-star-inserted"><span _ngcontent-ng-c2430989347=""> of Next
Insurance, Inc., and understand that AP Intego (</span><a _ngcontent-ng-c2430989347="" target="_blank" href="https://track.nextinsurance.com/links?serial=90104">licenses</a><span _ngcontent-ng-c2430989347="">) is a wholly owned subsidiary
of Next Insurance, Inc.</span></span><!----><!----></div><!----><!---->
<div _ngcontent-ng-c2430989347="" id="pxElement" class="px-element"></div>
</div>
<div _ngcontent-ng-c2430989347="" data-test="login-to-portal-link" class="p-sm_md login-to-portal ng-star-inserted"> Already have a NEXT Insurance account? <a _ngcontent-ng-c2430989347="">Log in</a></div><!---->
</form>Text Content
* 1 Start * 2 Coverage * 3 Application * 4 Quote * 5 Purchase LET'S GET YOU COVERED What type of work do you do? Accountant, Retail Stores State Search state ×New York × Email Address We only use your email to provide services. You can opt out at any time. Continue By clicking "Continue", you agree to the Terms of Use and Privacy Policy of Next Insurance, Inc., and understand that AP Intego (licenses) is a wholly owned subsidiary of Next Insurance, Inc. Already have a NEXT Insurance account? Log in Powered by Next First Insurance Agency, Inc. and AP Intego Insurance Group, LLC Terms of ServicePrivacy PolicyLicenses Please enable JavaScript to continue using this application.